Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $963.72 / $8,525.01 / $25,406.29	Facility		$963.72	$8,525.01	$25,406.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $539.00 / $808.60 / $1,925.46	Professional		$539.00	$808.60	$1,925.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,039.98 / $16,547.20 / $26,542.00	Facility		$4,039.98	$16,547.20	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $941.96 / $1,465.47 / $5,495.44	Professional		$941.96	$1,465.47	$5,495.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,394.89 / $1,698.13 / $6,910.09	Facility		$1,394.89	$1,698.13	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $670.50 / $1,191.96 / $2,115.44	Professional		$670.50	$1,191.96	$2,115.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $684.40 / $1,238.05 / $5,185.60	Facility		$684.40	$1,238.05	$5,185.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $667.68 / $1,228.23 / $2,997.94	Professional		$667.68	$1,228.23	$2,997.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.85 / $451.29 / $1,490.86	Professional		$78.85	$451.29	$1,490.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $967.61 / $1,386.90 / $1,490.75	Facility		$967.61	$1,386.90	$1,490.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $984.37 / $1,016.83 / $5,317.93	Facility		$984.37	$1,016.83	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $947.51 / $1,350.47 / $1,840.37	Professional		$947.51	$1,350.47	$1,840.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $853.34 / $1,253.91 / $1,805.25	Professional		$853.34	$1,253.91	$1,805.25
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,436.00 / $6,857.00	Facility		$702.00	$1,436.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $885.56 / $1,200.58 / $2,097.60	Professional		$885.56	$1,200.58	$2,097.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $613.15 / $628.33 / $821.30	Professional		$613.15	$628.33	$821.30